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Barth C, Kelly S, Nerland S, Jahanshad N, Alloza C, Ambrogi S, Andreassen OA, Andreou D, Arango C, Baeza I, Banaj N, Bearden CE, Berk M, Bohman H, Castro-Fornieles J, Chye Y, Crespo-Facorro B, de la Serna E, Díaz-Caneja CM, Gurholt TP, Hegarty CE, James A, Janssen J, Johannessen C, Jönsson EG, Karlsgodt KH, Kochunov P, Lois NG, Lundberg M, Myhre AM, Pascual-Diaz S, Piras F, Smelror RE, Spalletta G, Stokkan TS, Sugranyes G, Suo C, Thomopoulos SI, Tordesillas-Gutiérrez D, Vecchio D, Wedervang-Resell K, Wortinger LA, Thompson PM, Agartz I. In vivo white matter microstructure in adolescents with early-onset psychosis: a multi-site mega-analysis. Mol Psychiatry 2023; 28:1159-1169. [PMID: 36510004 PMCID: PMC10005938 DOI: 10.1038/s41380-022-01901-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Revised: 11/16/2022] [Accepted: 11/21/2022] [Indexed: 12/14/2022]
Abstract
Emerging evidence suggests brain white matter alterations in adolescents with early-onset psychosis (EOP; age of onset <18 years). However, as neuroimaging methods vary and sample sizes are modest, results remain inconclusive. Using harmonized data processing protocols and a mega-analytic approach, we compared white matter microstructure in EOP and healthy controls using diffusion tensor imaging (DTI). Our sample included 321 adolescents with EOP (median age = 16.6 years, interquartile range (IQR) = 2.14, 46.4% females) and 265 adolescent healthy controls (median age = 16.2 years, IQR = 2.43, 57.7% females) pooled from nine sites. All sites extracted mean fractional anisotropy (FA), mean diffusivity (MD), radial diffusivity (RD), and axial diffusivity (AD) for 25 white matter regions of interest per participant. ComBat harmonization was performed for all DTI measures to adjust for scanner differences. Multiple linear regression models were fitted to investigate case-control differences and associations with clinical variables in regional DTI measures. We found widespread lower FA in EOP compared to healthy controls, with the largest effect sizes in the superior longitudinal fasciculus (Cohen's d = 0.37), posterior corona radiata (d = 0.32), and superior fronto-occipital fasciculus (d = 0.31). We also found widespread higher RD and more localized higher MD and AD. We detected significant effects of diagnostic subgroup, sex, and duration of illness, but not medication status. Using the largest EOP DTI sample to date, our findings suggest a profile of widespread white matter microstructure alterations in adolescents with EOP, most prominently in male individuals with early-onset schizophrenia and individuals with a shorter duration of illness.
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Affiliation(s)
- Claudia Barth
- Department of Psychiatric Research, Diakonhjemmet Hospital, Oslo, Norway.
- Norwegian Centre for Mental Disorders Research (NORMENT), Institute of Clinical Medicine, University of Oslo, Oslo, Norway.
| | - Sinead Kelly
- Department of Psychosis Studies, King's College London, London, UK
| | - Stener Nerland
- Department of Psychiatric Research, Diakonhjemmet Hospital, Oslo, Norway
- Norwegian Centre for Mental Disorders Research (NORMENT), Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Neda Jahanshad
- Imaging Genetics Center, Mark & Mary Stevens Neuroimaging & Informatics Institute, Keck School of Medicine, University of Southern California, Marina del Rey, CA, USA
| | - Clara Alloza
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, IiSGM, CIBERSAM, Madrid, Spain
| | - Sonia Ambrogi
- Laboratory of Neuropsychiatry, Santa Lucia Foundation IRCCS, Rome, Italy
| | - Ole A Andreassen
- Norwegian Centre for Mental Disorders Research (NORMENT), Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Norwegian Center for Mental Disorders Research (NORMENT), Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Dimitrios Andreou
- Department of Psychiatric Research, Diakonhjemmet Hospital, Oslo, Norway
- Norwegian Centre for Mental Disorders Research (NORMENT), Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet & Stockholm Health Care Services, Stockholm Region, Stockholm, Sweden
| | - Celso Arango
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, IiSGM, CIBERSAM, Madrid, Spain
- School of Medicine, Universidad Complutense, Madrid, Spain
| | - Inmaculada Baeza
- Department Child and Adolescent Psychiatry and Psychology, 2017SGR881 Institute of Neuroscience, Hospital Clinic Barcelona. CIBERSAM. August Pi i Sunyer Biomedical Research Institute (IDIBAPS), University of Barcelona, Barcelona, Spain
| | - Nerisa Banaj
- Laboratory of Neuropsychiatry, Santa Lucia Foundation IRCCS, Rome, Italy
| | - Carrie E Bearden
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, UCLA, Los Angeles, CA, USA
- Department of Psychology, UCLA, Los Angeles, CA, USA
| | - Michael Berk
- Deakin University, Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Barwon Health, Geelong, Australia
| | - Hannes Bohman
- Department of Neuroscience, Child and Adolescent Psychiatry, Uppsala University, Uppsala, Sweden
- Department of Clinical Science and Education Södersjukhuset, Karolinska Institutet, Stockholm, Sweden
| | - Josefina Castro-Fornieles
- Department Child and Adolescent Psychiatry and Psychology, 2017SGR881 Institute of Neuroscience, Hospital Clinic Barcelona. CIBERSAM. August Pi i Sunyer Biomedical Research Institute (IDIBAPS), University of Barcelona, Barcelona, Spain
| | - Yann Chye
- Turner Institute for Brain and Mental Health and School of Psychological Sciences, Monash University, Melbourne, VIC, Australia
| | - Benedicto Crespo-Facorro
- Hospital Universitario Virgen del Rocío, Universidad de Sevilla, Department of Psychiatry, CIBERSAM, IBiS-CSIC, Sevilla, Spain
| | - Elena de la Serna
- Department Child and Adolescent Psychiatry and Psychology, 2017SGR881 Institute of Neuroscience, Hospital Clinic Barcelona. CIBERSAM. August Pi i Sunyer Biomedical Research Institute (IDIBAPS), University of Barcelona, Barcelona, Spain
| | - Covadonga M Díaz-Caneja
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, IiSGM, CIBERSAM, Madrid, Spain
- School of Medicine, Universidad Complutense, Madrid, Spain
| | - Tiril P Gurholt
- Norwegian Centre for Mental Disorders Research (NORMENT), Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Norwegian Center for Mental Disorders Research (NORMENT), Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | | | - Anthony James
- Highfield Unit, Warneford Hospital, Oxford, UK
- Department of Psychiatry, University of Oxford, Oxford, UK
| | - Joost Janssen
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, IiSGM, CIBERSAM, Madrid, Spain
| | - Cecilie Johannessen
- Norwegian Centre for Mental Disorders Research (NORMENT), Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Erik G Jönsson
- Norwegian Centre for Mental Disorders Research (NORMENT), Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet & Stockholm Health Care Services, Stockholm Region, Stockholm, Sweden
| | - Katherine H Karlsgodt
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, UCLA, Los Angeles, CA, USA
- Department of Psychology, UCLA, Los Angeles, CA, USA
| | - Peter Kochunov
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MA, USA
| | - Noemi G Lois
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, IiSGM, Madrid, Spain
| | - Mathias Lundberg
- Department of Neuroscience, Child and Adolescent Psychiatry, Uppsala University, Uppsala, Sweden
- Department of Clinical Science and Education Södersjukhuset, Karolinska Institutet, Stockholm, Sweden
| | - Anne M Myhre
- Section of Child and Adolescent Mental Health Research, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Saül Pascual-Diaz
- Magnetic Resonance Imaging Core Facility, August Pi i Sunyer Biomedical Research Institute (IDIBAPS), University of Barcelona, Barcelona, Spain
| | - Fabrizio Piras
- Laboratory of Neuropsychiatry, Santa Lucia Foundation IRCCS, Rome, Italy
| | - Runar E Smelror
- Department of Psychiatric Research, Diakonhjemmet Hospital, Oslo, Norway
- Norwegian Centre for Mental Disorders Research (NORMENT), Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Gianfranco Spalletta
- Laboratory of Neuropsychiatry, Santa Lucia Foundation IRCCS, Rome, Italy
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA
| | - Therese S Stokkan
- Department of Psychiatric Research, Diakonhjemmet Hospital, Oslo, Norway
- Norwegian Centre for Mental Disorders Research (NORMENT), Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Gisela Sugranyes
- Department Child and Adolescent Psychiatry and Psychology, 2017SGR881 Institute of Neuroscience, Hospital Clinic Barcelona. CIBERSAM. August Pi i Sunyer Biomedical Research Institute (IDIBAPS), University of Barcelona, Barcelona, Spain
| | - Chao Suo
- Turner Institute for Brain and Mental Health and School of Psychological Sciences, Monash University, Melbourne, VIC, Australia
| | - Sophia I Thomopoulos
- Imaging Genetics Center, Mark & Mary Stevens Neuroimaging & Informatics Institute, Keck School of Medicine, University of Southern California, Marina del Rey, CA, USA
| | - Diana Tordesillas-Gutiérrez
- Department of Radiology, Marqués de Valdecilla University Hospital, Valdecilla Biomedical Research Institute IDIVAL, Santander (Cantabria), Spain
- Advanced Computing and e-Science, Instituto de Física de Cantabria (UC-CSIC), Santander (Cantabria), Spain
| | - Daniela Vecchio
- Laboratory of Neuropsychiatry, Santa Lucia Foundation IRCCS, Rome, Italy
| | - Kirsten Wedervang-Resell
- Norwegian Center for Mental Disorders Research (NORMENT), Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Laura A Wortinger
- Department of Psychiatric Research, Diakonhjemmet Hospital, Oslo, Norway
- Norwegian Centre for Mental Disorders Research (NORMENT), Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Paul M Thompson
- Imaging Genetics Center, Mark & Mary Stevens Neuroimaging & Informatics Institute, Keck School of Medicine, University of Southern California, Marina del Rey, CA, USA
| | - Ingrid Agartz
- Department of Psychiatric Research, Diakonhjemmet Hospital, Oslo, Norway
- Norwegian Centre for Mental Disorders Research (NORMENT), Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet & Stockholm Health Care Services, Stockholm Region, Stockholm, Sweden
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2
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Gurholt TP, Lonning V, Nerland S, Jørgensen KN, Haukvik UK, Alloza C, Arango C, Barth C, Bearden CE, Berk M, Bohman H, Dandash O, Díaz‐Caneja CM, Edbom CT, van Erp TGM, Fett AJ, Frangou S, Goldstein BI, Grigorian A, Jahanshad N, James AC, Janssen J, Johannessen C, Karlsgodt KH, Kempton MJ, Kochunov P, Krabbendam L, Kyriakopoulos M, Lundberg M, MacIntosh BJ, Rund BR, Smelror RE, Sultan A, Tamnes CK, Thomopoulos SI, Vajdi A, Wedervang‐Resell K, Myhre AM, Andreassen OA, Thompson PM, Agartz I. Intracranial and subcortical volumes in adolescents with early-onset psychosis: A multisite mega-analysis from the ENIGMA consortium. Hum Brain Mapp 2022; 43:373-384. [PMID: 33017498 PMCID: PMC8675418 DOI: 10.1002/hbm.25212] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Revised: 09/11/2020] [Accepted: 09/13/2020] [Indexed: 12/27/2022] Open
Abstract
Early-onset psychosis disorders are serious mental disorders arising before the age of 18 years. Here, we investigate the largest neuroimaging dataset, to date, of patients with early-onset psychosis and healthy controls for differences in intracranial and subcortical brain volumes. The sample included 263 patients with early-onset psychosis (mean age: 16.4 ± 1.4 years, mean illness duration: 1.5 ± 1.4 years, 39.2% female) and 359 healthy controls (mean age: 15.9 ± 1.7 years, 45.4% female) with magnetic resonance imaging data, pooled from 11 clinical cohorts. Patients were diagnosed with early-onset schizophrenia (n = 183), affective psychosis (n = 39), or other psychotic disorders (n = 41). We used linear mixed-effects models to investigate differences in intracranial and subcortical volumes across the patient sample, diagnostic subgroup and antipsychotic medication, relative to controls. We observed significantly lower intracranial (Cohen's d = -0.39) and hippocampal (d = -0.25) volumes, and higher caudate (d = 0.25) and pallidum (d = 0.24) volumes in patients relative to controls. Intracranial volume was lower in both early-onset schizophrenia (d = -0.34) and affective psychosis (d = -0.42), and early-onset schizophrenia showed lower hippocampal (d = -0.24) and higher pallidum (d = 0.29) volumes. Patients who were currently treated with antipsychotic medication (n = 193) had significantly lower intracranial volume (d = -0.42). The findings demonstrate a similar pattern of brain alterations in early-onset psychosis as previously reported in adult psychosis, but with notably low intracranial volume. The low intracranial volume suggests disrupted neurodevelopment in adolescent early-onset psychosis.
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Affiliation(s)
- Tiril P. Gurholt
- Norwegian Center for Mental Disorders Research (NORMENT), Division of Mental Health and AddictionOslo University HospitalOsloNorway
- Norwegian Center for Mental Disorders Research (NORMENT), Institute of Clinical MedicineUniversity of OsloOsloNorway
- Department of Psychiatric ResearchDiakonhjemmet HospitalOsloNorway
| | - Vera Lonning
- Norwegian Center for Mental Disorders Research (NORMENT), Institute of Clinical MedicineUniversity of OsloOsloNorway
- Department of Psychiatric ResearchDiakonhjemmet HospitalOsloNorway
| | - Stener Nerland
- Norwegian Center for Mental Disorders Research (NORMENT), Institute of Clinical MedicineUniversity of OsloOsloNorway
- Department of Psychiatric ResearchDiakonhjemmet HospitalOsloNorway
| | - Kjetil N. Jørgensen
- Norwegian Center for Mental Disorders Research (NORMENT), Institute of Clinical MedicineUniversity of OsloOsloNorway
- Department of Psychiatric ResearchDiakonhjemmet HospitalOsloNorway
| | - Unn K. Haukvik
- Norwegian Center for Mental Disorders Research (NORMENT), Division of Mental Health and AddictionOslo University HospitalOsloNorway
- Department of Adult Mental Health, Institute of Clinical MedicineUniversity of OsloOsloNorway
| | - Clara Alloza
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental HealthHospital General Universitario Gregorio Marañón, IiSGM, CIBERSAMMadridSpain
| | - Celso Arango
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental HealthHospital General Universitario Gregorio Marañón, IiSGM, CIBERSAMMadridSpain
- School of MedicineUniversidad ComplutenseMadridSpain
| | - Claudia Barth
- Norwegian Center for Mental Disorders Research (NORMENT), Institute of Clinical MedicineUniversity of OsloOsloNorway
| | - Carrie E. Bearden
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human BehaviorUCLALos AngelesCaliforniaUSA
- Department of PsychologyUCLALos AngelesCaliforniaUSA
| | - Michael Berk
- IMPACT, The Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Deakin UniversityGeelongVictoriaAustralia
- Orygen Youth Health Research CenterThe Florey Institute for Neuroscience and Department of PsychiatryParkvilleVictoriaAustralia
| | - Hannes Bohman
- Center for Psychiatry Research, Department of Clinical NeuroscienceKarolinska Institutet and Stockholm Health Care Services, Stockholm Region, Stockholm, SwedenStockholmSweden
- Department of Neuroscience, Child and Adolescent PsychiatryUppsala UniversityUppsalaSweden
- Department of Clinical Science and Education SödersjukhusetKarolinska InstitutetStockholmSweden
| | - Orwa Dandash
- IMPACT, The Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Deakin UniversityGeelongVictoriaAustralia
| | - Covadonga M. Díaz‐Caneja
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental HealthHospital General Universitario Gregorio Marañón, IiSGM, CIBERSAMMadridSpain
- School of MedicineUniversidad ComplutenseMadridSpain
| | - Carl T. Edbom
- Center for Psychiatry Research, Department of Clinical NeuroscienceKarolinska Institutet and Stockholm Health Care Services, Stockholm Region, Stockholm, SwedenStockholmSweden
| | - Theo G. M. van Erp
- Clinical Translational Neuroscience Laboratory, Department of Psychiatry and Human BehaviorUniversity of California IrvineIrvineCaliforniaUSA
- Center for the Neurobiology of LearningUniversity of California Irvine and MemoryIrvineCaliforniaUSA
| | - Anne‐Kathrin J. Fett
- Department of PsychologyCity, University of LondonLondonUK
- Department of Psychosis StudiesIoPPNLondonUK
- Department of Clinical, Neuro and Developmental PsychologyVU AmsterdamAmsterdamNetherlands
| | - Sophia Frangou
- Department of PsychiatryIcahn School of Medicine at Mount SinaiNew YorkNew YorkUSA
| | - Benjamin I. Goldstein
- Center for Youth Bipolar Disorder, Sunnybrook Health Science CenterTorontoOntarioCanada
- Department of Psychiatry and PharmacologyUniversity of TorontoCanada
| | - Anahit Grigorian
- Center for Youth Bipolar Disorder, Sunnybrook Health Science CenterTorontoOntarioCanada
| | - Neda Jahanshad
- Imaging Genetics Center, Mark and Mary Stevens Neuroimaging and Informatics Institute, Keck School of MedicineUniversity of Southern CaliforniaMarina del ReyCaliforniaUSA
| | - Anthony C. James
- Department of PsychiatryUniversity of OxfordOxfordUK
- Oxford Health Foundation NHS TrustOxfordUK
| | - Joost Janssen
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental HealthHospital General Universitario Gregorio Marañón, IiSGM, CIBERSAMMadridSpain
- School of MedicineUniversidad ComplutenseMadridSpain
| | - Cecilie Johannessen
- Norwegian Center for Mental Disorders Research (NORMENT), Institute of Clinical MedicineUniversity of OsloOsloNorway
| | - Katherine H. Karlsgodt
- Department of PsychologyUCLALos AngelesCaliforniaUSA
- Department Psychiatry and Biobehavioral SciencesUCLALos AngelesCaliforniaUSA
| | | | - Peter Kochunov
- Maryland Psychiatric Research Center, Department of PsychiatryUniversity of Maryland School of MedicineBaltimoreMarylandUSA
| | - Lydia Krabbendam
- Department of Clinical, Neuro and Developmental PsychologyVU AmsterdamAmsterdamNetherlands
| | - Marinos Kyriakopoulos
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology, and NeuroscienceKing's College LondonLondonUK
- National and Specialist Children's Inpatient Unit (Acorn Lodge), South London and Maudsley NHS Foundation TrustBeckenhamUK
| | - Mathias Lundberg
- Center for Psychiatry Research, Department of Clinical NeuroscienceKarolinska Institutet and Stockholm Health Care Services, Stockholm Region, Stockholm, SwedenStockholmSweden
- Department of Neuroscience, Child and Adolescent PsychiatryUppsala UniversityUppsalaSweden
- Department of Clinical Science and Education SödersjukhusetKarolinska InstitutetStockholmSweden
- The Department of Clinical Science and EducationKI SÖSStockholmSweden
| | - Bradley J. MacIntosh
- Hurvitz Brain Sciences, Sunnybrook Research InstituteTorontoOntarioCanada
- Department of Medical BiophysicsUniversity of TorontoOntarioCanada
| | - Bjørn Rishovd Rund
- Department of PsychologyUniversity of OsloOsloNorway
- Department of ResearchVestre Viken Hospital TrustDrammenNorway
| | - Runar E. Smelror
- Norwegian Center for Mental Disorders Research (NORMENT), Institute of Clinical MedicineUniversity of OsloOsloNorway
- Department of Psychiatric ResearchDiakonhjemmet HospitalOsloNorway
| | - Alysha Sultan
- Department of PsychiatryIcahn School of Medicine at Mount SinaiNew YorkNew YorkUSA
- Department of PharmacologyUniversity of TorontoTorontoOntarioCanada
| | - Christian K. Tamnes
- Norwegian Center for Mental Disorders Research (NORMENT), Institute of Clinical MedicineUniversity of OsloOsloNorway
- Department of Psychiatric ResearchDiakonhjemmet HospitalOsloNorway
- PROMENTA Research Center, Department of PsychologyUniversity of OsloOsloNorway
| | | | - Ariana Vajdi
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human BehaviorUCLALos AngelesCaliforniaUSA
| | - Kirsten Wedervang‐Resell
- Norwegian Center for Mental Disorders Research (NORMENT), Division of Mental Health and AddictionOslo University HospitalOsloNorway
| | - Anne M. Myhre
- Child and Adolescent Psychiatry Unit, Division of Mental Health and Addiction, Institute of Clinical MedicineUniversity of OsloOsloNorway
- Department of Psychiatric Research and Development, Division of Mental Health and AddictionOslo University HospitalOsloNorway
| | - Ole A. Andreassen
- Norwegian Center for Mental Disorders Research (NORMENT), Division of Mental Health and AddictionOslo University HospitalOsloNorway
- Norwegian Center for Mental Disorders Research (NORMENT), Institute of Clinical MedicineUniversity of OsloOsloNorway
| | - Paul M. Thompson
- Department of Psychiatry and PharmacologyUniversity of TorontoCanada
| | - Ingrid Agartz
- Norwegian Center for Mental Disorders Research (NORMENT), Institute of Clinical MedicineUniversity of OsloOsloNorway
- Department of Psychiatric ResearchDiakonhjemmet HospitalOsloNorway
- Center for Psychiatry Research, Department of Clinical NeuroscienceKarolinska Institutet and Stockholm Health Care Services, Stockholm Region, Stockholm, SwedenStockholmSweden
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3
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Hilland E, Johannessen C, Jonassen R, Alnæs D, Jørgensen KN, Barth C, Andreou D, Nerland S, Wortinger LA, Smelror RE, Wedervang-Resell K, Bohman H, Lundberg M, Westlye LT, Andreassen OA, Jönsson EG, Agartz I. Aberrant default mode connectivity in adolescents with early-onset psychosis: A resting state fMRI study. Neuroimage Clin 2021; 33:102881. [PMID: 34883402 PMCID: PMC8662331 DOI: 10.1016/j.nicl.2021.102881] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Revised: 11/05/2021] [Accepted: 11/06/2021] [Indexed: 12/14/2022]
Abstract
Abnormal default mode network (DMN) connectivity has been found in schizophrenia and other psychotic disorders. However, there are limited studies on early onset psychosis (EOP), and their results show lack of agreement. Here, we investigated within-network DMN connectivity in EOP compared to healthy controls (HC), and its relationship to clinical characteristics. A sample of 68 adolescent patients with EOP (mean age 16.53 ± 1.12 [SD] years, females 66%) and 95 HC (mean age 16.24 ± 1.50 [SD], females 60%) from two Scandinavian cohorts underwent resting state functional magnetic resonance imaging (rsfMRI). A group independent component analysis (ICA) was performed to identify the DMN across all participants. Dual regression was used to estimate spatial maps reflecting each participant's DMN network, which were compared between EOP and HC using voxel-wise general linear models and permutation-based analyses. Subgroup analyses were performed within the patient group, to explore associations between diagnostic subcategories and current use of psychotropic medication in relation to connectivity strength. The analysis revealed significantly reduced DMN connectivity in EOP compared to HC in the posterior cingulate cortex, precuneus, fusiform cortex, putamen, pallidum, amygdala, and insula. The subgroup analysis in the EOP group showed strongest deviations for affective psychosis, followed by other psychotic disorders and schizophrenia. There was no association between DMN connectivity strength and the current use of psychotropic medication. In conclusion, the findings demonstrate weaker DMN connectivity in adolescent patients with EOP compared to healthy peers, and differential effects across diagnostic subcategories, which may inform our understanding of underlying disease mechanisms in EOP.
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Affiliation(s)
- Eva Hilland
- Norwegian Centre for Mental Disorders Research NORMENT, Institute of Clinical Medicine, University of Oslo, Oslo, Norway; Faculty of Health Sciences, Oslo Metropolitan University, Norway.
| | - Cecilie Johannessen
- Norwegian Centre for Mental Disorders Research NORMENT, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Rune Jonassen
- Faculty of Health Sciences, Oslo Metropolitan University, Norway
| | - Dag Alnæs
- Bjørknes College, Oslo, Norway; Norwegian Centre for Mental Disorders Research NORMENT, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Kjetil N Jørgensen
- Norwegian Centre for Mental Disorders Research NORMENT, Institute of Clinical Medicine, University of Oslo, Oslo, Norway; Department of Psychiatric Research, Diakonhjemmet Hospital, Oslo, Norway
| | - Claudia Barth
- Norwegian Centre for Mental Disorders Research NORMENT, Institute of Clinical Medicine, University of Oslo, Oslo, Norway; Department of Psychiatric Research, Diakonhjemmet Hospital, Oslo, Norway
| | - Dimitrios Andreou
- Norwegian Centre for Mental Disorders Research NORMENT, Institute of Clinical Medicine, University of Oslo, Oslo, Norway; Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet & Stockholm Health Care Services, Stockholm Region, Stockholm, Sweden
| | - Stener Nerland
- Norwegian Centre for Mental Disorders Research NORMENT, Institute of Clinical Medicine, University of Oslo, Oslo, Norway; Department of Psychiatric Research, Diakonhjemmet Hospital, Oslo, Norway
| | - Laura A Wortinger
- Norwegian Centre for Mental Disorders Research NORMENT, Institute of Clinical Medicine, University of Oslo, Oslo, Norway; Department of Psychiatric Research, Diakonhjemmet Hospital, Oslo, Norway
| | - Runar E Smelror
- Norwegian Centre for Mental Disorders Research NORMENT, Institute of Clinical Medicine, University of Oslo, Oslo, Norway; Department of Psychiatric Research, Diakonhjemmet Hospital, Oslo, Norway
| | - Kirsten Wedervang-Resell
- Norwegian Centre for Mental Disorders Research NORMENT, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Hannes Bohman
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet & Stockholm Health Care Services, Stockholm Region, Stockholm, Sweden; Department of Neuroscience, Child and Adolescent Psychiatry, Uppsala University, Uppsala, Sweden; Department of Clinical Science and Education Södersjukhuset, Karolinska Institutet, Stockholm, Sweden
| | - Mathias Lundberg
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet & Stockholm Health Care Services, Stockholm Region, Stockholm, Sweden; Department of Neuroscience, Child and Adolescent Psychiatry, Uppsala University, Uppsala, Sweden; Department of Clinical Science and Education Södersjukhuset, Karolinska Institutet, Stockholm, Sweden
| | - Lars T Westlye
- Norwegian Centre for Mental Disorders Research NORMENT, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway; Department of Psychology, University of Oslo, Oslo, Norway
| | - Ole A Andreassen
- Norwegian Centre for Mental Disorders Research NORMENT, Institute of Clinical Medicine, University of Oslo, Oslo, Norway; Norwegian Centre for Mental Disorders Research NORMENT, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Erik G Jönsson
- Norwegian Centre for Mental Disorders Research NORMENT, Institute of Clinical Medicine, University of Oslo, Oslo, Norway; Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet & Stockholm Health Care Services, Stockholm Region, Stockholm, Sweden
| | - Ingrid Agartz
- Norwegian Centre for Mental Disorders Research NORMENT, Institute of Clinical Medicine, University of Oslo, Oslo, Norway; Department of Psychiatric Research, Diakonhjemmet Hospital, Oslo, Norway; Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet & Stockholm Health Care Services, Stockholm Region, Stockholm, Sweden
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4
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Smelror RE, Johannessen C, Wedervang-Resell K, Jørgensen KN, Barth C, Andreou D, Ueland T, Andreassen OA, Myhre AM, Rund BR, Agartz I. Cognitive impairment profile in adolescent early-onset psychosis using the MATRICS Battery: Age and sex effects. Neuropsychology 2021; 35:300-309. [PMID: 33970663 DOI: 10.1037/neu0000723] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
Objective: To examine cognitive performance, stratified by age and sex, in adolescents with early-onset psychosis (EOP), relative to the healthy adolescent standardized scores for the MATRICS Consensus Cognitive Battery (MCCB). Method: Seventy-one EOP patients (12-18 years) were included in the study. Raw scores of nine MCCB tests were converted into age- and sex-corrected T scores comprising six domains and global cognition (cognitive composite score). Patient performance, relative to the healthy reference group, was examined using one sample t-tests (reference T score mean of 50). Age effects were examined using one-way analyses of variance between three age groups (12-14 years, 15-16 years, 17-18 years). Sex differences were examined using independent samples t tests. Results: The patients performed significantly worse than the healthy reference group in all MCCB domains, with a global deficit of -1.6 SD below the reference. Across the domains, the impairments varied from -1.4 SD in speed of processing to -0.6 SD in visual learning and reasoning and problem-solving. Significant age effects were found in speed of processing, attention/vigilance, reasoning and problem-solving, and global cognition. The oldest age group showed largest impairments relative to the age- and sex-corrected reference. Female patients had a significantly higher mean T score in verbal learning compared to males. Conclusions: This study provides a MCCB performance profile in EOP, stratified by age and sex, relative to adolescent standardized scores. The results can be used to improve cognitive remediation strategies and subsequent functional outcome, in adolescent EOP and related clinical populations. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
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Affiliation(s)
- Runar E Smelror
- NORMENT Center of Excellence, Institute of Clinical Medicine, University of Oslo
| | - Cecilie Johannessen
- NORMENT Center of Excellence, Institute of Clinical Medicine, University of Oslo
| | | | - Kjetil N Jørgensen
- NORMENT Center of Excellence, Institute of Clinical Medicine, University of Oslo
| | - Claudia Barth
- NORMENT Center of Excellence, Institute of Clinical Medicine, University of Oslo
| | - Dimitrios Andreou
- NORMENT Center of Excellence, Institute of Clinical Medicine, University of Oslo
| | - Torill Ueland
- NORMENT Center of Excellence, Institute of Clinical Medicine, University of Oslo
| | - Ole A Andreassen
- NORMENT Center of Excellence, Institute of Clinical Medicine, University of Oslo
| | - Anne M Myhre
- Division of Mental Health and Addiction, Oslo University Hospital
| | | | - Ingrid Agartz
- NORMENT Center of Excellence, Institute of Clinical Medicine, University of Oslo
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Wedervang-Resell K, Friis S, Lonning V, Smelror RE, Johannessen C, Reponen EJ, Lyngstad SH, Lekva T, Aukrust P, Ueland T, Andreassen OA, Agartz I, Myhre AM. Increased interleukin 18 activity in adolescents with early-onset psychosis is associated with cortisol and depressive symptoms. Psychoneuroendocrinology 2020; 112:104513. [PMID: 31761332 DOI: 10.1016/j.psyneuen.2019.104513] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2019] [Revised: 09/14/2019] [Accepted: 11/12/2019] [Indexed: 12/14/2022]
Abstract
OBJECTIVE Evidence indicates that the pathophysiology of adult psychosis involves immune dysregulation, but its associations with stress are often not considered. The inflammatory cytokine interleukin (IL)-18, which is elevated in adult schizophrenia, is suggested to be sensitive to stress. We compared the associations of IL-18 with cortisol and clinical variables in adolescents with early-onset psychosis (EOP) aged 12-18 years and age-matched healthy controls (HC). METHOD We measured serum IL-18, IL-18 binding protein (IL-18BP), IL-18 receptor accessory protein (IL-18RAP), IL-18 receptor 1 (IL-18R1) and cortisol, and calculated the IL-18/IL-18BP ratio in patients (n = 31) and HC (n = 60). Psychotic symptoms were assessed using the Positive and Negative Syndrome Scale and depressive symptoms by the Mood and Feelings Questionnaire-Child version (MFQ-C). Bivariate correlation analysis was used to explore relationships between IL-18/IL-18BP ratio and cortisol, depression and other clinical characteristics. Hierarchical multiple linear regression analysis was used to assess their individual contributions to the variance of the IL-18/IL-18BP ratio. RESULTS Patients had significantly higher IL-18 levels and IL-18/IL-18BP ratios than HC, but similar IL-18BP, IL-18RAP and IL-18R1. Both cortisol (R2 change = 0.05) and the MFQ-C score (R2 change = 0.09) contributed significantly to the variance in IL-18/IL-18BP ratios after controlling for confounders. CONCLUSION We found increased IL-18 system activity in adolescents with EOP. Cortisol and depressive symptoms each contributed to the variance in the IL-18/IL-18BP ratio. Our findings support activation of inflammatory pathways in adolescent psychosis and suggest interactions between stress, inflammation and depressive symptoms in EOP.
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Affiliation(s)
- Kirsten Wedervang-Resell
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway; Division of Mental Health and Addiction, Department of Psychiatric Research and Development, Oslo University Hospital, Oslo, Norway.
| | - Svein Friis
- Division of Mental Health and Addiction, Department of Psychiatric Research and Development, Oslo University Hospital, Oslo, Norway; Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Vera Lonning
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway; Department of Psychiatric Research, Diakonhjemmet Hospital, Oslo, Norway
| | - Runar E Smelror
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway; Department of Psychiatric Research, Diakonhjemmet Hospital, Oslo, Norway
| | - Cecilie Johannessen
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway; Department of Psychiatric Research, Diakonhjemmet Hospital, Oslo, Norway
| | - Elina J Reponen
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Siv H Lyngstad
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Tove Lekva
- Research Institute of Internal Medicine, Oslo University Hospital Rikshospitalet, Oslo, Norway
| | - Pål Aukrust
- Research Institute of Internal Medicine, Oslo University Hospital Rikshospitalet, Oslo, Norway; Section of Clinical Immunology and Infectious Diseases, Oslo University Hospital, Rikshospitalet, Norway; Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Thor Ueland
- Research Institute of Internal Medicine, Oslo University Hospital Rikshospitalet, Oslo, Norway; K.G. Jebsen Thrombosis Research and Expertise Center, University of Tromsø, Tromsø, Norway; Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Ole A Andreassen
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Ingrid Agartz
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway; Department of Psychiatric Research, Diakonhjemmet Hospital, Oslo, Norway; Centre for Psychiatric Research, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Anne M Myhre
- Division of Mental Health and Addiction, Department of Psychiatric Research and Development, Oslo University Hospital, Oslo, Norway; Child and Adolescent Psychiatry Unit, Division of Mental Health and Addiction, Institute of Clinical Medicine, University of Oslo, Norway
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Wedervang-Resell K, Friis S, Lonning V, Smelror RE, Johannessen C, Agartz I, Ulven SM, Holven KB, Andreassen OA, Myhre AM. Lipid alterations in adolescents with early-onset psychosis may be independent of antipsychotic medication. Schizophr Res 2020; 216:295-301. [PMID: 31791814 DOI: 10.1016/j.schres.2019.11.039] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2019] [Revised: 07/21/2019] [Accepted: 11/22/2019] [Indexed: 12/16/2022]
Abstract
BACKGROUND Dyslipidemia and insulin resistance (HOMA-IR) are cardiovascular risk factors prevalent in patients with psychosis. Whether these factors are intrinsic or affected by lifestyle or antipsychotic medication (AP) is unclear. Therefore, we investigated lipid profiles, HOMA-IR, and psychotic phenotypes in patients aged 12-18 years with early-onset psychosis (EOP) with and without AP exposure. METHOD We measured fasting total cholesterol (TC), high-density lipoprotein cholesterol (HDLC), triglycerides (TG), insulin, and glucose in patients with EOP (n = 39) and healthy controls (HC) (n = 66). Diet information was not available. Negative symptoms were assessed using the Positive and Negative Syndrome Scale (PANSS). We used univariate analysis of variance to compare TC/HDL-C ratios and TG and HOMA-IR values, controlling for body mass index (BMI) and AP exposure. We assessed the explained variance of having EOP using multiple regression analysis. RESULTS Patients with and without AP exposure had significantly higher TC/HDL-C (p = 0.003, p = 0.029) and TG values (p < 0.001, p = 0.021) than HC. Significantly increased HOMA-IR scores were found only in AP-exposed patients (p = 0.037). EOP significantly increased the explained variance for TC/HDL-C and TG, but not for HOMA-IR. Patients with a PANSS negative score > 21 had significantly higher levels of TG than those with low scores (p = 0.032). CONCLUSION Our results suggest that lipid alterations predate AP treatment in adolescents with EOP. Higher levels of negative symptoms and AP further increase metabolic risk. The preliminary findings propose that subclinical dyslipidemia may be intrinsic to EOP.
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Affiliation(s)
- Kirsten Wedervang-Resell
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of clinical Medicine, University of Oslo, Oslo, Norway; Division of Mental Health and Addiction, Department of Psychiatric Research and Development, Oslo University Hospital, Oslo, Norway.
| | - Svein Friis
- Division of Mental Health and Addiction, Department of Psychiatric Research and Development, Oslo University Hospital, Oslo, Norway
| | - Vera Lonning
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of clinical Medicine, University of Oslo, Oslo, Norway; Department of Psychiatric Research, Diakonhjemmet Hospital, Oslo, Norway
| | - Runar E Smelror
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of clinical Medicine, University of Oslo, Oslo, Norway; Department of Psychiatric Research, Diakonhjemmet Hospital, Oslo, Norway
| | - Cecilie Johannessen
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of clinical Medicine, University of Oslo, Oslo, Norway; Department of Psychiatric Research, Diakonhjemmet Hospital, Oslo, Norway
| | - Ingrid Agartz
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of clinical Medicine, University of Oslo, Oslo, Norway; Department of Psychiatric Research, Diakonhjemmet Hospital, Oslo, Norway; Centre for Psychiatric Research, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Stine M Ulven
- Department of Nutrition, Institute for Basic Medical Sciences, University of Oslo, PO Box 1046, 0317 Blindern, Oslo, Norway
| | - Kirsten B Holven
- Department of Nutrition, Institute for Basic Medical Sciences, University of Oslo, PO Box 1046, 0317 Blindern, Oslo, Norway
| | - Ole A Andreassen
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of clinical Medicine, University of Oslo, Oslo, Norway
| | - Anne M Myhre
- Division of Mental Health and Addiction, Department of Psychiatric Research and Development, Oslo University Hospital, Oslo, Norway; Child and Adolescent Psychiatry Unit, Division of Mental Health and Addiction, Institute of clinical Medicine, University of Oslo, Norway
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